NPI | 1376858332 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 11722) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA 11722 NP) |
Enumeration Date | 2010-08-15 |
Last Update Date | 2018-03-09 |